PSYCHOPATHOLOGY

Question 1

Define statistical infrequency

Answer 1

person’s trait, thinking / behaviour would be considered to be an indication of abnormality if it was found to be statistically rare

Question 2

Strength of statistical infrequency

Answer 2

-real world application
-used in clinical practice for diagnosis of psychological disorder and assess severity of symptoms
-Beck’s depressions inventory (BDI) assesses severity of depressions symptoms - score of 30+ = severe depression
-SI is useful for diagnostic and assessment procedures for psych disorders

Question 3

Weakness of statistical infrequency

Answer 3

-Unusual characteristics can be positive as well as negative
-e.g. if there’re highly intelligent people with IQ>130 but we wouldn’t consider it as abnormal even though they’re displaying unusual behaviour
-being unusual at 1 end of psych spectrum wouldn’t warrant a diagnosis for a disorder
-SI cannot be used as a sole basis for diagnosing abnormality

Question 4

Define deviations from social norms

Answer 4

concerns behaviour that is different from the accepted standards of behaviour in a community

Question 5

Strength of DFSN

Answer 5

-real world application
-DFSN can be used in clinical process of diagnosing psych disorders eg antisocial personality disorder and schizotypal personality disorder
-symptoms of these disorders are all DFSN
-DFSN can be used to diagnose personality disorders

Question 6

Weakness of DFSN

Answer 6

-Variation between social norms in different cultures
-eg hearing noises =normal in some cultures but in UK= abnormal
-diagnosis of disorders may differ from culture to culture due to variations from social norms
-makes DFSN hard to judge in different cultures/situations

Question 7

Define failure to function adequately

Answer 7

occurs when someone is unable to cope with the ordinary demands of day to day living

Question 8

Proposement of F2FA

Answer 8

-Rosenhan and Seligman (1989)
-signs that can be used to determine when someone isn’t coping:
- no longer conforms to standard interpersonal rules (space, eye contact etc)
-experience severe personal distress
-irrational behaviour
-Diagnosis can only be made if someone is showing F2FA

Question 9

Strength of F2FA

Answer 9

-Represents a suitable threshold for when professional help is needed
-around 25% of people in UK will experience a mental health problem. However many people press on in the face of fairly severe symptoms
-It tends to be at the point that we cease to function adequately that people seek professional help / noticed by others.
-treatment and services can be target to those who need them the most

Question 10

Weakness of F2FA

Answer 10

-Easy to label non-standard life choices as abnormal
-can be very hard to say when someone is F2FA when they have chosen to deviated from social norms
-not having a job may seem like F2FA for some but people with alternative lifestyles choose to live ‘off-grind’
-people who make unusual choices are at risk of being labelled as abnormal

Question 11

Define deviation from ideal mental health

Answer 11

-occurs when someone doesn’t meet the criteria for a good mental health
-Johoda (1958) - DFIMH focuses on what makes people normal and then considers those who deviated from this to be abnormal

Question 12

Strength of DFIMH

Answer 12

-highly comprehensive
-Johoda’s concept of IMH includes a range of criteria fro distinguishing mental health from mental disorders and covers reasons why we might seek help with it
-so individuals mental health would be discusses meaningfully with professionals eg psychiatrists
-IMH provides a checklist against which we can assess ourselves and others and discuss psych issues with professionals

Question 13

Weakness of DFIMH

Answer 13

-different elements aren’t equally applicable across a range of cultures
-J’s criteria for IMH is firmly located in context of US, Europe and concepts of self-actualisation would probably be dismissed as self-indulgent in much of the world e.g. germany
-what defines success, social, love-lives are different in every culture
-difficult to apply concept of IMH from one culture to another

Question 14

Define phobia

Answer 14

anxiety disorder which interferes with daily living
-it is an instance of irrational fear that produces a conscious avoidance of the feared object/situation

Question 15

Behavioural characteristics of phobias

Answer 15

-panic
-avoidance
-endurance

Question 16

Emotional characteristics of phobias

Answer 16

-anxiety
-fear
-unreasonable

Question 17

cognitive characteristics of phobias

Answer 17

-selective attention to phobic stimulus
-irrational beliefs
-cognitive distortions

Question 18

Behavioural approach to explaining phobias

Answer 18

-emphasises role of learning in acquisition of behaviour.
-Mowrer (1960) proposed two-process model. States that phobias are acquired by classical conditioning and then maintained because of operant conditioning

Question 19

Acquisition by classical conditioning

Answer 19

-cc involves learning by association to what we initially have no fear (neutral stimulus) with something already triggers a fear response (unconditioned stimulus)
-Watson and Rayner (1920) - created phobia in Little Albert (9 month old). He showed no unusual anxiety at start of study. Shown white rat he tried playing with it but researcher made a loud frightening noise by banging iron bar close to his ear. noise = UCS which creates an UCR ofd fear. When rat (NS) becomes associated with UCS and both now produce fear. He displayed fear when he saw the rat (NS). Rat is now a learned or CS that produces a CR.
This conditioning then generalised to similar objects - showed Albert fury objects eg fur coat, Watson wearing Santa beard made out of cotton balls and Albert displayed distress at sight of all these.

Question 20

Maintenance by operant conditioning

Answer 20

-responses acquired by classical conditioning usually tend to decline overtime but phobias are often long lasting - due to operant conditioning
-o.c. takes place when behaviour is reinforced (rewarded) or punished - reinforcement = increase frequency of behaviour
-Mowrer - whenever we avoid phobic stimulus we successfully escape fear and anxiety that we would have experience if we remained there. This reduction in fear reinforces avoidance behaviour s phobia is maintained

Question 21

Strengths of behavioural approach to explaining phobias

Answer 21

-real world application in exposure therapies eg systematic desensitisation
-two process model suggests that phobias are maintained by avoidance of phobic stimulus and this is important in explaining why people with phobias benefit from being exposed to phobia stimulus
-once avoidance behaviour is prevented it ceases to be reinforced by anxiety reduction and avoidance therefore declines - phobia avoided = phobia cured
-shows value of two-process approach as it identifies a means of treating phobias

-evidence for a link between bad experiences and phobia
-Ad De Jongh et al (2006) found 73% of people with fear of dental treatment has experiences a traumatic experience mostly involving dentistry (others experienced being victim of violent crime)
-compared to control group of people with low dental anxiety (21% experienced traumatic event
-confirms association between stimulus (dentistry) and an UCR (pain) does lead to development of phobia

Question 22

Limitation of behaviour approach to explaining phobias

Answer 22

-two process model does not account for cognitive aspects of phobias
- in case of phobias the key behaviour is avoidance of phobic stimulus but we know that phobias aren’t simply avoidance responses - also have significant cognitive components
-eg people hold irrational beliefs about phobic stimulus (thinking spider is dangerous)
-two-process model explains avoidance behaviour but doesn’t offer an adequate explanation for phobic cognitions so two-process model does not completely explain symptoms of phobia

-Counterpoint
-not al phobias appear following a bad experience
-eg phobias of snake occur in populations where very few people have any experience of snakes let alone traumatic experiences
-not all frightening experiences lead to phobias
-means association between phobias and frightening experiences is not as strong as we would expect if behavioural theories provided a complete explanation

Question 23

Behavioural approach to treating phobias - systematic desensitisation (SD)

Answer 23

• reduce phobic anxiety through the principle of classical conditioning
• phobic stimulus is paired with relation instead of anxiety - learning through counterbalancing

Question 24

Processes of SD

Answer 24

1) Anxiety hierarchy - list of situations related to phobic stimulus that provoke anxiety. arranged in order from least to most frightening
2) relaxation - therapist teaches client to relax as deeply as possible. Can’t be afraid and relaxed at the same time (reciprocal inhibition)
3) exposure - exposed to phobia in a relaxed state. Takes place across several sessions. Successful treatment when client can stay relaxed in situations high at anxiety hierarchy

Question 25

Strengths of SD

Answer 25

- Evidence for effectiveness -Gilroy followed up 34 people who had SD for SD for spider phobia in three 45 minute sessions. At both 3 and 33 months the SD group were less fearful than control group treated with relaxation but not exposure -SD is likely to be helpful for people with phobias -For people with leaning disabilities this is the only sensible treatment available today -people with learning disabilities may struggle with cognitive therapy that require rational thought -they may be confused and distressed with flooding -SD = more appropriate treatment for people with learning disabilities who have phobias

Question 26

Flooding therapy

Answer 26

-exposing people with a phobia to their phobic stimulus but without a gradual build up in an anxiety hierarchy -involves immediate exposure to frightening situation -typically longer that SD sessions l- 1 session lasting 2-3 hours

Question 27

Process of flooding

Answer 27

-stops phobic responses very quickly - without the option of avoidance behaviour, the client quickly learns the phobic stimulus as harmless -classical conditioning - extinction -a learned response is estnguised when the conditioned stimulus (eg dog) is encountered without the unconditioned stimulus (eg being bitten). the result is that the conditioned stimulus no longer produces the conditioned response (fear) -at the same point client may achieve relaxation in presence of phobic stimulus because they may become exhausted by their own fear response

Question 28

Strength of flooding treatment

Answer 28

-cost effective -clinically effective and not expensive -can work as little as 1 session as opposed to 10 sessions for SD to achieve same result. Even allowing for a longer session (perhaps 3 hours), making it more cost effective -more people can be treated at the same cost with flooding than SD/ other therapies

Question 29

Weakness of flooding treatment

Answer 29

- traumatic - highly unpleasant -confronting one's phobic stimulus provokes tremendous anxiety -Schumacher (2015) found that participants and therapists rated flooding as significantly more stressful than SD. This raises ethical issues for psychs of knowingly causing stress -suggests that overall therapists may avoid using this treatment

Question 30

Define unipolar/ major depressions disorder

Answer 30

characterised by a persistent feeling of sadness /lack of interest in outside stimuli

Question 31

Define bipolar depressive disorder

Answer 31

oscillating state between depression and mania

Question 32

Define depression

Answer 32

mental disorder characterised by changes of mood

Question 33

Behavioural characteristics of depression

Answer 33

-reduced activity levels. May be opposite (psychomotor agitation) struggle to relax and may eve end up pacing up and down -disruption to sleep and eating behaviour - may experience insomnia, increased need for sleep (hypersomnia), same with appetite -agression and self harm

Question 34

Emotional characteristics of depression

Answer 34

-lowered mood - describe themselves as 'worthless' and 'empty' -anger - can be directed to self or others -lowered self esteem

Question 35

Cognitive characteristics of depression

Answer 35

-poor concentration - unable to stick to tasks as they usually would -attending to and dwelling on the negative - pay more attention to negative aspects and ignore positives. Also have bias towards recalling unhappy events rather than happy ones -absolutist thinking - 'black and white thinking' means when a situation is unfortunate they tend to see it as an absolute disaster

Question 36

Ellis's ABC model

Answer 36

-Good mental health is result of rational thinking. Conditions likes anxiety and depression (poor mental health) result from irrational thoughts A (activating state) - focused on situations in which irrational thoughts are triggered by external events. we get depressed when we experience negative events and these trigger irrational beliefs B (beliefs) - belief that we must always succeed = musturbation (major disaster when something doesn't go smoothly), utopianism = life is always meant to be fair C (consequences) - when activating event triggers belief there are emotional + behavioural consequences eg belief they must succeed and fail = trigger depression

Question 37

Beck's cognitive theory of depression

Answer 37

-people's cognitions create a vulnerability to depression. 3 parts to cognitive vulnerability: 1) faulty information processing - paying attention to the negatives and ignoring positive in a situation. also includes 'black and white' thinking 2) negative self schemas - interpret all info about ourselves in a negative way 3) negative triad - person develops a dysfunctional view on self due to 3 type of negative thinking: negative view on self, world and future (cognitive triad)

Question 38

Strength of Ellis's ABC model

Answer 38

-real world application for psych treatment of depression -ellis's approach = rational emotive behaviour therapy -rigorously arguing with a depressed person the therapist can alter irrational beliefs that make them unhappy. There's evidence support -REBT have real world value

Question 39

Limitation of Ellis's ABC model

Answer 39

-doesn't explain endogenous depression -model only explains depressions that triggered by a life event but some cases of depression aren't traceable to life events and its not obvious what leads the person to become depressed at a particular time (endogenous depression) E's ABC model is less useful for explaining endogenous depression -model can only explain some cases of depression and is therefore a partial explanation

Question 40

Process of cognitive approach to treating depression

Answer 40

1) assessment will take place. (patients + CB therapist work together to clarify patient's problems 2) they jointly identify goals and put together a plan to achieve them 3)key point - identify where there might be negative / irrational thoughts that'll benefit from challenge 4) work on changing these thoughts and put more effective behaviours in place

Question 41

CBT - cognitive element

Answer 41

-one of the central tasks is to identify where there might be negative/irrational thoughts that'll benefit from challenge -behaviour element - CBT then involves working to change irrational thoughts and put more effective behaviours into place

Question 42

CBT - Beck's cognitive triad

Answer 42

-challenge thoughts directly -aims to get patients to test the reality of their negative belief -set hw - 'patient as a scientist' -hw can be used as evidence to prove the patient's statements are incorrect

Question 43

CBT - Ellis's rational emotive behaviour therapy (REBT)

Answer 43

-dysfunctional thoughts=thoughts that are likely to interfere with person's happiness -central technique is to identify and challenge irrational thoughts -REBT extends ABC model to ABCDE. D = dispute E = effect

Question 44

CBT - behavioural activation

Answer 44

- depression can lead to people to become isolated as they would avoid difficult situations, this can make symptoms worse -goal of behavioural activation = decrease avoidance + isolation and increase engagement activities. This has been shown to improve mood

Question 45

Cognitive approach to treating depression - A03

Answer 45

-evidence supporting its effectiveness for treating depression > eg M

Question 46

Cognitive approach to treating depression - A03

Answer 46

-evidence supporting its effectiveness for treating depression > eg March (2007) compared CBT to antidepressants and combo of both treatments when treating 337 depressed adolescence. After 36 weeks,81% of CBT group, 81% of antidepressant group and 86% of CBT+ antidepressant group significantly improved> CBT is just as effective when used on own and more when used alongside antidepressants > CBT widely seen as first choice in health care systems -Lack of effectiveness for severe cases and learning disabilities > severe clients cannot motivate themselves to engage with cognitive work of CBT and may not be able to pay attention in sessions> complex rational thinking involved in CBT is unsuitable for clients with learning disabilities (Sturmey)-any form of psychotherapy isn't suitable for learning difficulties> CBT may only be appropriate for specific range of people -HOWEVER there's evidence now that challenges this> Lewis and Lewis (2016) concluded that CBT was as effective as antidepressants and behavioural therapies for severe depression. Taaylor (2006) - if used appropriately CBT is effective for people with learning disabilities> suitable for wider range of people than once thought -High relapse rates > CBT is quite effective in tackling depressive symptoms but there's concerns over how long the benefits last > recent studies suggest long-term outcomes aren't as good as had been assumed > eg Ali (2017) assessed depression in 439 clients every month for following a course of CBT. 42% relapsed into depression within 6 months and 53% relapsed within a year of ending treatment > CBT may need to be repeated continuously